For a city that was once known as "the city that knows how," the streets of San Francisco have become a shameful, unhealthy place. The news report of the unacceptable conditions at the San Francisco Public Library is just one example of the city's inability to tackle the pervasive problem of street people acting badly.

I'm purposefully avoiding the use of the label "homeless people" because it unfairly implies that homelessness equates to unacceptable public behavior. Many homeless people behave responsibly and do the best they can in spite of limited resources or opportunities.

Let me say that I am not some dainty, pampered woman who doesn't want to see or deal with unpleasantness. I am a nurse who worked at San Francisco General for four years and did public health nursing in the city before moving to Sonoma County. I am well aware of the mental and physical health issues and of the concomitant social complexities involved. However, having knowledge and compassion for those who may be ill, homeless, addicted or whatever does not mean I must excuse what is going on in the streets and in public places such as the library.

Last week, I had a need to use the public library and was appalled by what I saw: urine in the elevators, with one elevator unusable because a man had taken up residency with a stacked grocery cart and all; wild-eyed folks ranting, raving and threatening others; people sleeping on the floors, etc. That night on the TV news, the reporters said steps were being taken to deal with these library issues in the form of more security people who would kick out badly behaving individuals and possibly ban them from ever entering again.

While I support enforcement of decency laws, is that really the only answer to this problem? Kick people out into Civic Center Plaza or other parts of the city where problems are even worse? Fine them? Be serious!

There is no one, simple answer to this complex problem, but the objections I've heard against enforcing laws and ordinances aimed at unacceptable behavior are ridiculous. Enforcement is aimed at harmful behaviors, not homelessness.

Advocacy groups for the homeless are very misguided when they support a failed bill like Assemblyman Tom Ammiano's "homeless bill of rights," which would allow homeless people in California to sit, sleep and panhandle on public property without facing penalties from law enforcement, thus negating the sit-lie ordinance approved by San Francisco voters in 2010.

Do people really believe that allowing people to sleep on filthy streets, where they are constantly rejected and shunned, exposed to abuse and disease, are in those people's best interest? Most experts who deal with behavior problems, regardless of the cause, will tell you that structure and strict limits-setting is needed to get an individual started on a healthy path - a "tough love" approach, if you will. Letting people run amok does more harm than good for all involved.

What are the rights of the ordinary person on the streets? Do they just have to accept walking through urine and feces, being constantly harassed and ranted at?

There are better solutions out there. I don't believe there is a shortage of private and public monies to implement those solutions. It is a matter of caring enough and having the will to do the right thing.

Barbara Surian, a registered nurse, is a health care provider and educator. She is a frequent visitor to San Francisco.